Sen. Bernie Sanders says his plan to implement a taxpayer financed, universal coverage health care system in this country is based on a relatively simple concept - expand the federal Medicare program to include all Americans.
Sanders says Medicare currently covers all people 65 and over, is largely financed through a payroll tax, and allows individuals to choose their own doctors.
He says the problems that have developed with the Affordable Care Act demonstrate that it is not the long term solution to provide universal access to health care in this country.
"The system today, despite the gains of the Affordable Care Act still, is not where it should be, too many problems,” said Sanders. “Deductibles are too high, co-payments are too high, premiums are too high, prescription drug costs are outrageously high and people want change."
Sanders says the current stalemate in Congress over the future of the Affordable Care Act offers the perfect time to start the discussion about his Medicare for All plan.
"So I think now is the moment to begin the debate about whether or not health care should be a right of all people and I think it should. And second of all, how we can create a cost effective quality system for all of our people?" said Sanders.
Sanders acknowledges that it will take some time to move to a single-payer system. That's why he says he'll introduce a bill next month that expands the eligibility of Medicare to people between the ages of 55 and 64.
"That's an interesting idea and one of the proposals that I will be bringing forth shortly, which I don't think Republicans will support, will be to lower the age for Medicare eligibility to 55 years of age,” said Sanders. “That is one way to phase it in."
Sanders says a second short term approach that he also supports, is to legalize the re-importation of drugs from Canada "where the prices for the same exact medicine that we use is substantially lower."
Retired Middlebury College political science professor Eric Davis says the people that Sanders needs to win over in this public policy debate are individuals who have relatively good employer sponsored health care policies. Davis says this group of consumers needs to see the benefits of Sanders' plan.
"That what he's proposing would be A) better, B) less expensive and C) would lead to better health outcomes without D) restricting their choice of doctors and providers," said Davis.
Davis says Sanders' health care agenda is also part of Sanders' effort to have the Democratic Party adopt more progressive policies on many social and economic issues.
"It's also a way, and this is part of his larger political strategy, to move the Democratic Party in a more progressive direction as we gear up for the 2018 midterms and then the 2020 presidential election," said Davis.
Some single-payer advocates believe it should be a litmus test for all Democratic candidates, but Sanders doesn't agree with that approach.
"So I don't see it as a litmus test, but what I do see is as the public, the general population, moves more and more in the direction of a Medicare for All, you're seeing more and more elected officials, more and more candidates, moving in that direction as well," said Sanders.
A number of Democratic Congressional leaders have expressed concern about Sanders plan.
For instance, House Minority leader Nancy Pelosi says the number one health care priority for the Democrats should be developing ways to strengthen the Affordable Care Act. She also believes that efforts to enact sweeping changes to the nation's health care system should be tried first at the state level.